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Post 9-11 gets E5 housing allowance because they can qualify for the EDU bill offered post 9-11 under Ch 35. everyone else gets 750+/- per month stipend for Ch 31.

I put in my NOD about 60 days ago. The letter back states it can take them over a year to do the Review/SOC, and after that I have to file a fm 9 if I still want to appeal. I think at this stage, no matter which way I go, I won't get to the VBA before Feb 2019. The info that I have read states that if the new RAMP program does not grant my appeal then when they begin in Oct 2018 they will put the RAMP participants into the front of the line for the new appeals setup. Alternatively, if I stay in the current legacy system, my appeal will not make it to the VA by then (unlikely). If the SOC takes a year, then my form 9 will not be filed until Mar 2019 or later either way and it will go through the new system anyway. The same people will still be there as well. With all that, I will go ahead and opt in for the RAMP.

I see the 1980 and 1981 NOD info. Did they back pay you to then? What happened between 81 and 98? (Thats a long time for an appeal.) There was a claim made in 80/81, I take it that was shortly after discharge? I see that you had appealed the 1980 denial but nothing after that until 1998 +/-. Did you get anything back informing you they had closed the appeal for any reason? I also saw that they didn't have your medical records back in 80/81 (?) when they denied your SC, but they did have them in 1998 when they granted SC. Were the medical records in the government's hands all of that time?

OKC was a terrorist act. I would think that PTSD for that incident would qualify if you were AD Military on site/assignment at the time of the explosion. Can you document your presence? This would be a stressor. You said multiple stressors, were they all during active duty (AD)?

addiction is a symptom of the problem if you are SC for the problem, they cover the symptoms and effects so if your liver goes south they can SC it as secondary to your PTSD

Upper extremity radiculopathy would have to come from thoracic or cervical spine Thoracic is rated with the lumbar, but most of the time thoracic is not a problem, in the upper extremity radiculopathy...that comes from the cervical spine (See myotomes here) I would wonder what the nexus that you gave them said about the upper extremity radiculopathy because it cannot be connected without an etiology that ties it as secondary to a primary SC condition (like you legs would be connected through your lumbar spine) You will probably have to dig in to this and maybe get a new nexus on the upper extremity radiculopathy to succeed. I would guess that's why it was deferred, but you will only be sure when you get the BBE (big brown envelope) in the mail.

TDIU is because you can not work. I ended up losing my business because of my back, out of work 1.5 years before 60% disability kicked in. (I almost lost everything.) IF you get a statement from employer that they make special exceptions for you because of your disability, then it may be sheltered employment and you can work but the VA will put it under a microscope and check every detail, so you should study up if you go that way. If not, just the fact that you "are working" will go against you. Its a double edged sword... Alternatively, have you looked at the VR&E program yet? They put me in college for a 4 year degree to replace my loss of employment. I could not run my business because of the physical work load, but just like you, I am not ready to quit and go out to pasture. Over 30% you have a good shot, but just like all VA benefits, study up and follow the reg's, get ready by being informed and knowing what it takes to qualify to get what you want from the VA. Chapter 31 VR& E info here; https://www.disabledveterans.org/chapter-31-voc-rehab-page/

It might fly as a clear and indisputable error (CUE) because they denied the TDIU based on a reduction that never occured. I do not think they could give a valid response to a request for TDIU until your rating was determined. The basis for denial was clearly erroneous. (see a lawyer, backpay on this should be enough to get them to carry this for you no charge)

So you were not approved for SC on your spine and it is in appeals now? Back pay will only go to the date that you put your claim in. If you are in appeals now, your award will be the date you initially applied for disability. The law will not allow then to backdate entitlement any further. If you were turned down years before and didn't appeal, the only way to get back pay that far back would be if the VA committed a CUE, and you would want a lawyer for that issue. A lot of technical grounds on appeals because it starts to get adversarial then on. I had fusion from S1 to L3, they gave me 3 months convalescent pay at 100%, could have done 6 months the surgeon asked me what I wanted and I picked college (began VR&E the next month as a 60% disabled).

You can inquire at 800-827-1000 about status. Also, open an EBenefits account to check on status too.

I spent 3 1/2 hours, then 2 hours, and finally 45 minutes on the WH complaint line detailing facts that the VA had on a case and documenting how the information was ignored. So many of the rating people refuse to or are ignorant of the M21-1. I have spent way to much time teaching them what their job is, because I learn the facts contained in the USC, the CFR and the M21-1 that relate to my claim and I wont accept mistakes by the RO. You are your own best advocate. Face it, if you give someone else responsibility to do it for you, and that someone has hundreds of other people to advocate for, then you only get a fraction of the energy you yourself are willing to invest in the battle.

ETS was 1984 In 2015 I filed claim, award was backdated to 2014. I had no clue that I would be eligible for SC of anything due to the huge void of info about it during out processing.

Code 5055 : If the entire knee joint has been replaced by a prosthesis, then the condition is rated 100% for the first year after the surgery. (This period is mainly for the VA, but the DoD will also use it if the veteran is placed on TDRL before being permanently separated). After the 1-year period, the condition is given a permanent rating. If there is weakness and severe pain with motion, then it is rated 60%. If the pain is not severe, but does limit the range of motion, then it is rated under code 5256 if it is frozen, or under codes 5261 or 5262 , discussed below, if it is not frozen. The minimum rating for a total knee replacement, however, is 30% regardless of how much motion it has. This code is only for total knee replacements. Partial replacements are rated on any symptoms that they cause, like limited motion . Source :http://www.militarydisabilitymadeeasy.com/kneeandleg.html If you have more pain that would be considered severe, you can be rated higher. Check the link here and follow the rating codes to what other conditions you may have and how they should be rated.

I dont think anyone can answer this without access to your CFile at this time. The RO may have enough info to SC your cervical spine, but needs info on the Thoracolumbar and a medical opinion. If the Examiner gave a neg report on that, you may not get SC on it, but you can still get an IMO/IME to contradict a negative opinion. When your Ebenefits acct shows that your in prep for notification, it will be too late to submit any more info, so dont wait if you dont already have an IMO on the NEXUS for what they want opinions on. CPT 99090 is just review of records, so they do want a thorough check done by the examiner regarding your medical records. CPT 99205 is A comprehensive history; A comprehensive examination; Medical decision making of high complexity.

If they remanded the appeal for the RO to determine the correct rating, the RO would stop any claim on the same issue until that appeal remand was complete. Does your EBenefits account show anything on appeal, pending action?

The time it takes to put in a correction or add necessary evidence/examinations (etc) that would necessitate a SSOC will be far shorter than if they remand and you have to do it all over again. Remember that the RO is going to review your case either way. If you request a reconsideration and they deny you you burn time. If you go straight to the appeal instead, the senior rating official will still review your claim and can approve it if there is an error or issue an SOC if not. The time it takes to get an SOC is not much more than for reconsideration, and done correctly the chances of getting approval are equal or better. You can submit new evidence in either case. Reconsideration prior to filing a NOD could be effective, however you have to have solid grounds for them to change a decision. I had 2 C&P exams and both of them missed 90% of the symptoms I had on my Radiculopathy. They also claimed they used my medical file and the specialists exam and nexus that I submitted, but all of that contradicted the C&P's DBQ. They granted my request for reconsideration due to overwhelming evidence that they already had when they gave me 10%. I ended up with a 40% rating based on facts that the VA already had. (It would have been a major embarrassment to the VA to try to take it to the BVA, so it would have been fixed after my NOD anyways). You should consider how solid the facts are, and if you think what they omitted was significant enough, ask them for reconsideration in leu of NOD. Otherwise, put in your NOD and find an expert at sleep apnea and get a new IMO that will overcome all previous exams. This might cost $$, but done right you will recoup that $$ in your backpay. You cited that they failed to list evidence in your claim. This is a violation of 38 CFR 4.6. The list of evidence should include ALL of the information you submitted and/or an explanation why they discounted and refuse to validate the info your evidence provided. Depending on how serious the info is in the missing evidence, you may have a CUE. CUE must show that the info they omitted was enough to change the original outcome of the claim decision. You can only CUE 1 time on your claim so dont file CUE until you have to do it (usually in the end because they can reopen a claim years after its closed because of a significant error by the RO or BVA).

If you add new evidence, they will have to review it and issue a supplemental statement of the case (SSOC). Its basically the same thing as a reconsideration because if your new evidence carries the weight to get the claim approved, they have the authority to grant the claim still. Same thing goes if they screwed up, detail the exact error, document it, and submit it on a VA 21-4138.

The examiner has a duty to you to go through your records and use that info to develop his or her opinion. It's pretty obvious when you challenge a C&P exam because of a fly by night operation run by an examiner who doesn't do his/her job. They sent me a copy of my CFile a month ago that shows over 3k pages that the examiner should review, filter for applicable facts, and use to make an informed decision about any ??'s the VSR is asking about my condition. That's why they make the $$ for what they do, it is in the job description!!

Falsification of medical records is a felony in most states. Research your local statutes. Reporting the activity to the physicians licensing authority is one step to stop it. Document exactly what the provider falsified by referring to the statement they make that they reviewed your record, and everything that they said that directly contradicts your medical file. That is evidence that they falsified that part of the record. The MUST take the time to review the ENTIRE record and use that to render the information that they provide in your claim. The law places an expectation of professional competence on these people that far exceeds common competence of someone walking in off the street. They are also very bad at saying they did things but they dont actually do it. That is also a falsification of medical records. Take the status quo prior to the exam, and then when you note that something is obviously wrong in your examination record, go to you PCP and have them make a new record in your existing VAMC medical records. No you have medical records before, and after, the providers false report and your own statement that the examination did not include XYZ, as reported. The VAOIG is responsible for investigating crimes committed by VA Employees. I am doubtful that a States AG will get involved.

I just had an exam by them in Orlando. The office was small, NP conducted the exam. They sent me papers on the 11th for an exam on the 17th. NP's credentials were on it, but could not verify the training certificates. Wont be able to give feedback until I get a copy of the DBQ she submits.

Thx Broncovet...mine was not on the list but not taking chances...

Had something similar happen to one of the ppl I was working with. Widow applied to assume the Decd Vets position to complete SC claim. When the VA found out that he was Decd, they gathered up the DIC app, and denied both the DIC and SC and told us that it would be about a year to figure out if the widow could assume the Vets position. Did due diligence and studied the USC and CFR and M21 top to bottom on this. Called the WH complaint line. The VA Railroaded us, ignored evidence that had been submitted and failed to follow the laws from the top to the bottom, across the board and every which way in between (AKA-regular VA behavior). Was told that our claim was approved in 2 weeks. Waited...3 months go by and nothing. Called the WH complaint like again. Got a phone call from them back twice, before Christmas. Was told w/in a "few" weeks we would have a decision. Decision came in...ummm...allowing the widow to assume the Vets claim. Then the opened a "new" claim....I figured it looked better on the statistics they play with that way. I hit the WH complaint line again...screamed bloody murder because of what they were putting this Vets widow through. 60 days later we got the BBE with a 100% grant for cause of death, DIC approved and back pay. Dont stop fighting. Thats a core rule all Vets should abide by. If you are in the right, put it in writing, and stick to your guns. There are some good and some bad ppl in the VA, you just gotta keep kicking the machine until it works. White House VA Hotline: 1-855-948-2311 If you are sure you provided a copy of the long form certificate, make a WH complaint. Someone will check it, if its there, they had no reason to claim you didnt provide it, nor to close the complaint without proper consideration of all of the information in your file. Just going along with an appeal will put this out YEARS. Forcing a reconsideration takes months. If you are right, they will have no other choice because it IS a CUE just like Berta said. The thing you have on your side, and you should use it, is that you are the widow of a hero. A US Veteran, and the VA should NEVER treat them with that kind of disrespect.

Did it. I have been looking for other cases similar to this for reference so I can tell what it takes to win. Got plenty of time the NOD went in last month.

Hya Broncovet, I have a recent EMG and NCV from a non VA neurologist that shows atrophy and no deep tendon response in my ankles and only trace knee jerks in both knee's. Decreased strength in both legs, worse on left than right. I have documented that the axon nerve degeneration in my left leg is getting worse through both emg and ncv. The nerves were already damaged before the diabetic neuropathy began, and is attacking my left leg much worse because of the pre-existing damage (my opinion). There is no increase in any other extremity due to the Diabetic neuropathy. I cant find anything like this in the VBA, CVA or the M21-1. The boys at the VA 800 Peggy line have no clue. That's why I am looking here.

Here ya go Gastone What We Decided We made the following decision(s): Issue/Con ten ti on Percent (%) Continued left lower extremity radiculopathy, claimed as 40% partial paralysis sciatic nerve left leg and left foot drop Explanation • The evaluation of left lower extremity radiculopathy, claimed as partial paralysis sciatic nerve left leg and left foot drop is continued as 40 percent disabling. • Since there is a likelihood of improvement, the assigned evaluation is not considered permanent and is subject to a future review examination. • We have assigned a 40 percent evaluation for your left lower extremity radiculopathy ( claimed as partial paralysis sciatic nerve left leg and left foot drop) based on: • Moderately severe incomplete paralysis • A higher evaluation of 60 percent is not warranted for paralysis of the sciatic nerve unless the evidence shows nerve damage is severe with marked muscular atrophy.